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PEPP Final

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paramedic Pediatrics Quiz on PEPP Final, created by Jake Anderson on 23/08/2023.
Jake Anderson
Quiz by Jake Anderson, updated 8 months ago
Jake Anderson
Created by Jake Anderson 8 months ago
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Resource summary

Question 1

Question
A 7-year-old boy has difficulty breathing and is wheezing. Vital signs are BP 94/62, HR 128, and RR 32. What initial management should be performed?
Answer
  • Open the airway with the jaw-thrust maneuver.
  • Initiate bag-mask ventilation.
  • Place the patient in the Trendelenburg position.
  • Apply oxygen by non-rebreather mask.

Question 2

Question
A 4-month old infant who has had vomiting and diarrhea for the past 36 hours is lethargic, has a weak cry, and has mottled skin color. Vital signs are BP 62/46, HR 172, and RR 48. What do the signs and symptoms suggest?
Answer
  • Respiratory arrest.
  • Bacterial meningitis.
  • Cardiogenic abnormality.
  • Hypovolemic shock.

Question 3

Question
What is the priority treatment for a child who is seizing?
Answer
  • Open the airway.
  • Obtain a history.
  • Protect the cervical spine.
  • Insert an oropharyngeal airway.

Question 4

Question
What should be included in the treatment of thermal burns to the chest, abdomen, and legs?
Answer
  • Apply burn cream to burned areas.
  • Administer 100% oxygen.
  • Apply wet dressings to the burned areas.
  • Place the patient in the shock position.

Question 5

Question
A 2-year-old boy, who is alert and crying, has multiple lacerations and a deformed lower leg after being hit by a car. Additional assessment reveals that he has warm, dry, pink skin and bruising on the lateral right lower chest. What is the significance of the bruising to the right side of his chest?
Answer
  • The ribs are pliable, which makes organs more susceptible to underlying damage.
  • The chest wall muscles absorb the energy of impact and protect underlying organs from injury.
  • Rib fractures may be present because the chest wall is thin.
  • The intercostal muscles may be damaged because they are not well developed.

Question 6

Question
A 9-year-old patient fell down a steep incline after he rolled over the handlebars of his bicycle. He was not wearing a helmet and has begun vomiting. How should you manage this patient?
Answer
  • Elevate his head to 90 degrees.
  • Begin suctioning the airway.
  • Insert an oropharyngeal airway.
  • Open the airway with a head-tilt/chin-lift maneuver.

Question 7

Question
Which of the following patients may have injuries that suggest maltreatment?
Answer
  • A 4-year-old with bilateral bruises to the shins.
  • A 6-year-old with bruises throughout the back.
  • An 8-year-old with a laceration on the face.
  • A 10-year-old with several abrasions on the forearm.

Question 8

Question
The history provided by the caregiver of which of the following patients is inconsistent with the injury?
Answer
  • A 9-month-old infant with a bump on the head from falling out of a highchair reaching for a toy.
  • A 2½-year-old girl with a facial laceration from pulling a toaster off a counter.
  • A 2-year-old boy with several small, healing circular burns from running into a lit cigarette.
  • A 4-year-old boy with a wrist deformity from falling off a swing set at the park.

Question 9

Question
A newborn who was just delivered at home has cyanosis of the hands and feet, has a strong cry, and is moving her extremities vigorously. Vital signs are HR 164 and RR 52. What is the first step in managing this patient?
Answer
  • Dry her and then wrap her in a blanket.
  • Ventilate her with a bag-mask device.
  • Give high-flow oxygen by nonrebreather mask.
  • Maintain her airway using the jaw-thrust maneuver.

Question 10

Question
What is the best way to obtain information about the medical history of a 6-year-old girl who is on a ventilator and has a tracheostomy?
Answer
  • Ask the caregivers.
  • Ask the home health agency.
  • Contact the hospital where she is usually admitted.
  • Contact her physician.

Question 11

Question
In what position should the child in mild respiratory distress be placed?
Answer
  • Left lateral recumbent.
  • Position of comfort.
  • Supine with feet up.
  • On his or her right side.

Question 12

Question
An 8-year-old boy has been sick for 3 days. He has been experiencing nausea and diarrhea that has become progressively worse. He is semi-responsive with pale and diaphoretic skin. It is difficult to obtain a BP. Other vital signs are HR 54 and RR 10. What type of shock is this patient experiencing?
Answer
  • Cardiogenic.
  • Hypovolemic.
  • Septic.
  • Neurogenic.

Question 13

Question
An unrestrained 4-year-old girl was ejected during a two-vehicle motor vehicle collision. She is crying vigorously while moving her upper extremities. Her lower extremities appear deformed. What is the appropriate initial management of this patient?
Answer
  • Initiate cervical spine immobilization.
  • Initiate immobilization of the lower extremities.
  • Ventilate her with a bag-mask device.
  • Cover her with a blanket to keep her warm.

Question 14

Question
What is the most common cause of pediatric seizures?
Answer
  • Fever.
  • Head trauma.
  • Epilepsy.
  • Brain cancer.

Question 15

Question
When is it appropriate to use an AED in a witnessed pediatric cardiac arrest?
Answer
  • After 4 minutes of CPR.
  • As soon as possible.
  • Once the patient is in the ambulance.
  • When the ambulance is en route to the hospital.

Question 16

Question
A 7-year-old boy was having difficulty breathing during his physical education class. He appears tired and has audible wheezing. His vital signs are BP 98/66, HR 124 beats/min, and RR 32 breaths/min. What should the treatment of this patient include?
Answer
  • Preparing equipment for orotracheal intubation.
  • Initiating bag-mask ventilation at 12 breaths per minute.
  • Administering a nebulized beta-agonist medication.
  • Administering IV epinephrine 1:10,000.

Question 17

Question
What is the first step in caring for a patient with a tracheostomy tube who is having difficulty breathing?
Answer
  • Suction the tracheostomy tube.
  • Remove the tracheostomy tube.
  • Administer a nebulizer treatment with a beta-agonist medication.
  • Place a mask over the mouth and initiate bag-mask ventilation.

Question 18

Question
A 3-month-old infant is found unresponsive in his crib and has cool, mottled skin. His vital signs are HR 50 and RR 6. What is the initial treatment for this patient?
Answer
  • Establish IV access and administer an IV fluid bolus of 20 mL/kg.
  • Establish IV access and administer 0.01 mg/kg IV epinephrine 1:10,000.
  • Perform chest compressions and ventilate with a bag-mask device.
  • Initiate bag-mask ventilation and then reassess his skin color and heart rate.

Question 19

Question
Which of the following is an indication for insertion of an intraosseous needle?
Answer
  • You are unable to obtain peripheral access within 90 seconds in a 2-year-old child in impending arrest.
  • You have just arrived on scene to find a 3-month-old infant who has pink skin color and is lethargic following a seizure.
  • You have attempted all peripheral access sites in a 7-year-old child in respiratory failure.
  • The transport time is longer than 10 minutes for a 4-year-old boy in hypovolemic shock.

Question 20

Question
A 4-year-old boy fell down a 15-foot embankment and landed on packed dirt. He is unresponsive and has pale, cool skin and a capillary refill time of 4 seconds. Additional assessment reveals a 2 cm laceration on the left side of the forehead with minimal bleeding and a distended abdomen. His vital signs are BP 78/56, HR 146, and RR 48. What are the initial management steps for this patient?
Answer
  • Administer oxygen by nasal cannula, followed by a detailed physical exam before transport.
  • Manage blood loss from the forehead, establish IV access and give a slow infusion of fluids, and prepare for transport.
  • Administer oxygen by nonrebreather mask, establish intraosseous access and give a 10 mL/kg bolus, and place him in a high Fowler's position.
  • Maintain cervical spine stabilization, establish IV access and give a 20 mL/kg bolus, complete the spinal immobilization, and initiate transport.

Question 21

Question
What is the dysrhythmia for a 3-year-old with a heart rate of 180 beats/min, a narrow QRS complex, and a variable R-R interval called?
Answer
  • Supraventricular tachycardia.
  • Sinus tachycardia.
  • Ventricular tachycardia.
  • Pulseless electrical activity (PEA).

Question 22

Question
What is the initial airway management of a child who is seizing and has gurgling respirations?
Answer
  • Suction the oropharynx.
  • Insert an endotracheal tube.
  • Insert an oropharyngeal airway.
  • Administer bag-mask ventilation.

Question 23

Question
A 3-year-old boy reportedly fell down a flight of stairs and has a swollen, deformed right forearm. You also note several small, healing, circular burns on his arms and back. He appears quiet and withdrawn. What is the treatment of this patient?
Answer
  • Splint the forearm.
  • Establish IV access.
  • Cover the burns.
  • Contact law enforcement.

Question 24

Question
What is the best way to repair a break in a central line catheter?
Answer
  • Place a piece of silk tape horizontally over the break.
  • Remove the catheter.
  • Irrigate the catheter.
  • Clamp the catheter with a hemostat and gauze.

Question 25

Question
What is a contraindication to straightening the head and neck of a trauma patient during spinal immobilization?
Answer
  • Resistance to movement.
  • Multiple facial injuries.
  • Dilated pupils
  • Severe headache.

Question 26

Question
A 4-year-old semi-responsive boy has had difficulty breathing and a fever for 3 days. Vital signs are BP 60/40, HR 128, and RR 10. What initial management should be performed?
Answer
  • Open the airway and maintain cervical spine immobilization.
  • Open the airway and ventilate with a bag-mask device.
  • Place the patient in the Trendelenburg position.
  • Apply oxygen by nonrebreather mask at 15 L/min.

Question 27

Question
A 12-year-old boy was shot in the abdomen during a hunting accident. He has altered mental status and his skin is cool and clammy. Vital signs are BP 64/46, weak HR 142, and RR 38. What do the signs and symptoms suggest?
Answer
  • Tension pneumothorax.
  • Neurogenic shock.
  • Cardiac tamponade.
  • Hypovolemic shock.

Question 28

Question
What is the priority treatment for a child with altered mental status?
Answer
  • Open the airway.
  • Obtain a history.
  • Protect the cervical spine.
  • Obtain a blood glucose.

Question 29

Question
A 4-year-old boy is screaming and crying after he fell into a campfire. He has partial- and full-thickness burns on both arms. Vital signs are HR 140, BP 100/70, and RR 40. What should be done first in the treatment of thermal burns?
Answer
  • Apply burn cream to burned areas.
  • Remove any clothing that is still smoldering.
  • Apply moist dressings to all of the burned areas.
  • Place the patient in the shock position.

Question 30

Question
A 4-year-old boy is screaming and crying after he fell into a campfire. He has partial- and full-thickness burns on both arms. Vital signs are HR 140, BP 100/70, and RR 40. What should be done first in the treatment of thermal burns?
Answer
  • Apply burn cream to burned areas.
  • Remove any clothing that is still smoldering.
  • Apply moist dressings to all of the burned areas.
  • Place the patient in the shock position.

Question 31

Question
A 7-year-old semi-conscious patient rolled off of a 4-foot embankment when he fell off of his father's all-terrain vehicle. He was not wearing a helmet and has begun vomiting. How should you manage this patient?
Answer
  • Elevate his head to 90 degrees.
  • Begin suctioning the airway.
  • Insert a nasopharyngeal airway.
  • Perform a finger sweep maneuver.

Question 32

Question
A 2-year-old boy, who is alert and crying, has multiple lacerations and a deformed forearm after he was ejected from a vehicle. Additional assessment reveals that he has cool, moist, pale skin and bruising on the lateral right lower chest. What is the significance of the bruising to the right side of his chest?
Answer
  • The ribs are pliable, which makes organs more susceptible to underlying damage.
  • The chest wall muscles absorb the energy of impact and protect underlying organs from injury.
  • Rib fractures may be present because the chest wall is thin.
  • The intercostal muscles may be damaged because they are not well developed.

Question 33

Question
A 7-year-old semi-conscious patient rolled off of a 4-foot embankment when he fell off of his father's all-terrain vehicle. He was not wearing a helmet and has begun vomiting. How should you manage this patient?
Answer
  • Elevate his head to 90 degrees.
  • Begin suctioning the airway.
  • Insert a nasopharyngeal airway.
  • Perform a finger sweep maneuver.

Question 34

Question
Which of the following patients may have injuries that suggest maltreatment?
Answer
  • A 12-year-old with bilateral bruises to the shins
  • A 3-year-old with multiple bruises behind the ears.
  • An 8-year-old with a laceration on the face.
  • A 4-year-old with several abrasions on the hands and forearms.

Question 35

Question
The history provided by the caregiver of which of the following patients is inconsistent with the injury?
Answer
  • An 11-month-old infant with a bump on the head from falling out of a highchair at a restaurant reaching for the waiter.
  • A 2-year-old boy with circumferential burns to his feet and lower legs, from taking a hot bath.
  • A 3-year-old girl with a facial laceration from pulling a toaster off a counter.
  • A 4-year-old boy with a wrist deformity from falling off a swing set at the park.

Question 36

Question
A newborn who was just delivered at home has cyanosis of the hands and feet, a weak cry, and vigorous movement of the extremities. Vital signs are HR 86 and RR 52. What is the most important step in managing this patient?
Answer
  • Dry her and then wrap her in a blanket.
  • Ventilate her with a bag-mask device.
  • Give high-flow oxygen by a blow-by device.
  • Maintain her airway using the jaw-thrust maneuver.

Question 37

Question
What is the best way to obtain information about the medical history of a 6-year-old girl who is on a ventilator and has a tracheostomy?
Answer
  • Ask the patient's parents.
  • Ask the home health nurse.
  • Contact the nearest hospital.
  • Contact her pulmonologist.

Question 38

Question
In what position should the child in mild respiratory distress be placed?
Answer
  • Prone position.
  • Position of comfort.
  • Supine with feet up.
  • On his or her right side.

Question 39

Question
A 2-year-old girl has been having respiratory distress for about an hour. She has crackles noted in her lower lobes and her lips are cyanotic. She is semi-responsive with pale and diaphoretic skin. It is difficult to obtain a BP. Other vital signs are HR 270 and RR 60. What type of shock is this patient experiencing?
Answer
  • Cardiogenic.
  • Hypovolemic
  • Septic
  • Neurogenic

Question 40

Question
An 8-year-old girl fell from a tree house that is approximately 10 feet from the ground. She is screaming and crying due to a deformity of her right lower leg. What is the appropriate initial management of this patient?
Answer
  • Initiate cervical spine immobilization.
  • Initiate immobilization of the extremity.
  • Consider preparing the AED and applying pads.
  • Cover her with a blanket and apply heat packs.

Question 41

Question
After a seizure, patients are in a lethargic and confused state. What is this state known as?
Answer
  • Postictal.
  • Hyperglycemic.
  • Epileptic.
  • Grand mal.

Question 42

Question
What is the appropriate compression depth in a 6-month-old child in cardiac arrest?
Answer
  • 1 inch
  • 1.5 inches
  • 2 inches
  • 2.5 inches

Question 43

Question
A 2-year-old girl has been sick for 2 days. On arrival, she has a barklike cough and is extremely lethargic. Her vital signs are BP 66/P, HR 90, and RR 58. What should the treatment include for this patient?
Answer
  • Administering a nebulized beta-agonist medication.
  • Initiating bag-mask ventilation at 12 beats per minute.
  • Performing deep suction utilizing soft suction tubing.
  • Administering nebulized epinephrine 1:1,000.

Question 44

Question
A 3-year-old boy with a tracheostomy is cyanotic and anxious after a recent tracheostomy change by a new home health nurse. After suctioning and attempting to ventilate with a bag, what should the provider consider?
Answer
  • Suction the oropharynx.
  • Replace the tracheostomy tube.
  • Administer a nebulizer treatment with a beta-agonist medication.
  • Administer a nebulizer treatment with epinephrine 1:1,000.

Question 45

Question
After delivery of an unresponsive female newborn, you note she has central cyanosis and vital signs of HR 50 and RR 6. What is your initial treatment?
Answer
  • Establish IV access and administer an IV fluid bolus of 20 mL/kg.
  • Establish IV access and administer 0.01 mg/kg IV epinephrine 1:10,000.
  • Perform chest compressions and ventilate with a bag-mask device.
  • Initiate bag-mask ventilation and then reassess skin color and heart rate.

Question 46

Question
Which of the following would NOT be considered an approved site for intraosseous insertion?
Answer
  • Distal femur.
  • Proximal tibia.
  • Sternum.
  • Humerus.

Question 47

Question
A 12-year-old boy fell off of his dirt bike. He is unresponsive with pale, cool skin and has a capillary refill time of 4 seconds. Additional assessment reveals a deformed right forearm and a distended abdomen. His vital signs are BP 78/56, HR 146, and RR 48. What are the initial management steps for this patient?
Answer
  • Administer oxygen by nasal cannula, followed by a detailed physical exam before transport.
  • Stabilize the forearm, establish IV access and give a slow infusion of fluids, and prepare for transport.
  • Administer oxygen by nonrebreather mask, establish intraosseous access and give a 10 mL/kg bolus, and place him in a high Fowler's position.
  • Maintain cervical spine stabilization, establish IV access and give a 20 mL/kg bolus, complete the spinal immobilization, and initiate transport.

Question 48

Question
What is the dysrhythmia for a 16-year-old with a heart rate of 180 beats/min, a narrow QRS complex, and a nonvariable RR interval?
Answer
  • Supraventricular tachycardia.
  • Sinus tachycardia.
  • Ventricular tachycardia.
  • Pulseless electrical activity (PEA).

Question 49

Question
What is the initial airway management of an unrestrained child in a motor vehicle collision who has blood and broken teeth noted in the airway along with gurgling respirations?
Answer
  • Suction the oropharynx.
  • Insert an endotracheal tube.
  • Insert an oropharyngeal airway.
  • Administer bag-mask ventilation.

Question 50

Question
An 18-month-old boy reportedly fell down a flight of stairs and has a swollen, deformed right forearm. You also note several small, healing, circular bruises on his legs and back. What is the initial treatment of this patient?
Answer
  • Splint the forearm.
  • Establish IV access.
  • Cover the burns.
  • Contact law enforcement.

Question 51

Question
What is a contraindication to straightening the head and neck of a trauma patient during spinal immobilization?
Answer
  • Severe pain on movement.
  • Multiple facial injuries.
  • Unilateral dilated or sluggish pupils.
  • Severe headache.
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